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Performance of pre-transplant criteria in prediction of hepatocellular carcinoma progression and waitlist dropout / Sergio Iván Hoyos Duque  

Público ISBD Título : Performance of pre-transplant criteria in prediction of hepatocellular carcinoma progression and waitlist dropout Tipo de documento : documento electrónico Autores : Sergio Iván Hoyos Duque, Fecha de publicación : 2022 Títulos uniformes : Liver International Idioma : Inglés (eng) Palabras clave : delisting  liver cancer  outcomes  radiological progression Resumen : Background & aim: Liver transplantation (LT) selection models for hepatocellular carcinoma (HCC) have not been proposed to predict waitlist dropout because of tumour progression. The aim of this study was to compare the alpha-foetoprotein (AFP) model and other pre-LT models in their prediction of HCC dropout. Methods: A multicentre cohort study was conducted in 20 Latin American transplant centres, including 994 listed patients for LT with HCC from 2012 to 2018. Longitudinal tumour characteristics, and patterns of progression were recorded at time of listing, after treatments and at last follow-up over the waitlist period. Competing risk regression models were performed, and model's discrimination was compared estimating Harrell's adapted c-statistics. Results: HCC dropout rate was significantly higher in patients beyond (24% [95% CI 16-28]) compared to those within Milan criteria (8% [95% IC 5%-12%]; p 2 (adjusted SHR of 3.17 [CI 2.13-4.71]), c-index of 0.71 (95% CI 0.65-0.77; p = .09 vs Milan). Similar discrimination power for HCC dropout was observed between the AFP score and the Metroticket 2.0 model. In patients within Milan, an AFP score >2 points discriminated two populations with a higher risk of HCC dropout (SHR 1.68 [95% CI 1.08-2.61]). Conclusions: Pre-transplant selection models similarly predicted HCC dropout. However, the AFP model can discriminate a higher risk of dropout among patients within Milan criteria. Mención de responsabilidad : Federico Piñero, Marcos Thompson, Ilka Boin, Aline Chagas, Emilio Quiñonez, Carla Bermúdez, Mario Vilatobá, Luisa Santos, Margarita Anders, Sergio Hoyos Duque, Agnaldo Soares Lima, Josemaría Menendez, Martín Padilla, Jaime Poniachik, Rodrigo Zapata, Martín Maraschio, Ricardo Chong Menéndez, Linda Muñoz, Diego Arufe, Rodrigo Figueroa, Simone R. Perales, Claudia Maccali, Rodrigo Vergara Sandoval, Lucas McCormack, Adriana Varón, Sebastián Marciano, Juan Mattera, Flair Carrilho, Marcelo Silva Referencia : Liver Int. 2022 Aug;42(8):1879-1890. DOI (Digital Object Identifier) : 10.1111/liv.15223 PMID : 35304813 En línea : https://onlinelibrary.wiley.com/doi/10.1111/liv.15223 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6091 Performance of pre-transplant criteria in prediction of hepatocellular carcinoma progression and waitlist dropout [documento electrónico] / Sergio Iván Hoyos Duque,  . - 2022. Obra : Liver International Idioma : Inglés (eng) Palabras clave : delisting  liver cancer  outcomes  radiological progression Resumen : Background & aim: Liver transplantation (LT) selection models for hepatocellular carcinoma (HCC) have not been proposed to predict waitlist dropout because of tumour progression. The aim of this study was to compare the alpha-foetoprotein (AFP) model and other pre-LT models in their prediction of HCC dropout. Methods: A multicentre cohort study was conducted in 20 Latin American transplant centres, including 994 listed patients for LT with HCC from 2012 to 2018. Longitudinal tumour characteristics, and patterns of progression were recorded at time of listing, after treatments and at last follow-up over the waitlist period. Competing risk regression models were performed, and model's discrimination was compared estimating Harrell's adapted c-statistics. Results: HCC dropout rate was significantly higher in patients beyond (24% [95% CI 16-28]) compared to those within Milan criteria (8% [95% IC 5%-12%]; p 2 (adjusted SHR of 3.17 [CI 2.13-4.71]), c-index of 0.71 (95% CI 0.65-0.77; p = .09 vs Milan). Similar discrimination power for HCC dropout was observed between the AFP score and the Metroticket 2.0 model. In patients within Milan, an AFP score >2 points discriminated two populations with a higher risk of HCC dropout (SHR 1.68 [95% CI 1.08-2.61]). Conclusions: Pre-transplant selection models similarly predicted HCC dropout. However, the AFP model can discriminate a higher risk of dropout among patients within Milan criteria. Mención de responsabilidad : Federico Piñero, Marcos Thompson, Ilka Boin, Aline Chagas, Emilio Quiñonez, Carla Bermúdez, Mario Vilatobá, Luisa Santos, Margarita Anders, Sergio Hoyos Duque, Agnaldo Soares Lima, Josemaría Menendez, Martín Padilla, Jaime Poniachik, Rodrigo Zapata, Martín Maraschio, Ricardo Chong Menéndez, Linda Muñoz, Diego Arufe, Rodrigo Figueroa, Simone R. Perales, Claudia Maccali, Rodrigo Vergara Sandoval, Lucas McCormack, Adriana Varón, Sebastián Marciano, Juan Mattera, Flair Carrilho, Marcelo Silva Referencia : Liver Int. 2022 Aug;42(8):1879-1890. DOI (Digital Object Identifier) : 10.1111/liv.15223 PMID : 35304813 En línea : https://onlinelibrary.wiley.com/doi/10.1111/liv.15223 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6091

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A changing etiologic scenario in liver transplantation for hepatocellular carcinoma in a multicenter cohort study from Latin America / Sergio Iván Hoyos Duque  

Público ISBD Título : A changing etiologic scenario in liver transplantation for hepatocellular carcinoma in a multicenter cohort study from Latin America Tipo de documento : documento electrónico Autores : Sergio Iván Hoyos Duque, Fecha de publicación : 2018 Títulos uniformes : Clinics and Research in Hepatology and Gastroenterology Idioma : Inglés (eng) Palabras clave : Liver cancer  epidemiology  transplantation  steatohepatitis Resumen : Background and aim: Non-alcoholic fatty liver disease (NAFLD) is an increasing cause of hepatocellular carcinoma (HCC) and liver transplantation (LT). Our study focused on changing trends of liver related HCC etiologies during the last years in Latin America.Methods: From a cohort of 2761 consecutive adult LT patients between 2005 and 2012 in 17 different centers, 435 with HCC were included. Different periods including years 2005—2006, 2007—2008, 2009—2010 and 2011—2012 were considered. Etiology of liver disease was confirmed in the explant. Results: Participating LT centers per country included 2 from Brazil (n = 191), 5 transplant programs from Argentina (n = 98), 2 from Colombia (n = 65), 4 from Chile (n = 49), 2 from Mexico (n = 12), and 1 from Peru (n = 11) and Uruguay (n = 9). Chronic hepatitis C infection was the leading cause of HCC in the overall cohort (37%), followed by HBV (25%) and alcoholic liver disease (17%). NAFLD and cryptogenic cirrhosis accounted for 6% and 7%, respectively. While HCV decreased from 48% in 2005—06 to 26% in 2011—12, NAFLD increased from 1.8% to 12.8% during the same period, accounting for the third cause of HCC. This represented a 6-fold increase in NAFLD-HCC, whereas HCV had a 2-fold decrease. Patients with NAFLD were older, had lower pre-LT serum AFP values and similar 5-year survival and recurrence rates than non NAFLD. Conclusion: There might be a global changing figure regarding etiologies of HCC in Latin America. This epidemiological change on the incidence of HCC in the world, although it has been reported, should still be confirmed in prospective studies. Mención de responsabilidad : Federico Piñero, Paulo Costa, Yuri Longatto Boteon, Sergio Hoyos Duque, Sebastian Marciano, Margarita Anders, Adriana Varón, Alina Zerega, Jaime Poniachik, Alejandro Soza, Martín Padilla Machaca, Josemaría Menéndez, Rodrigo Zapata, Mario Vilatoba, Linda Muñoz, Martín Maraschio, Luis G Podestá, Lucas McCormack, Adrian Gadano, Ilka S F Fatima Boin, Parente García, Marcelo Silva, Latin American Liver Research, Education, Awareness Network LALREAN Referencia : Clin Res Hepatol Gastroenterol. 2018 Oct;42(5):443-452. DOI (Digital Object Identifier) : 10.1016/j.clinre.2018.03.014 PMID : 29773419 En línea : https://linkinghub.elsevier.com/retrieve/pii/S2210-7401(18)30074-3 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4181 A changing etiologic scenario in liver transplantation for hepatocellular carcinoma in a multicenter cohort study from Latin America [documento electrónico] / Sergio Iván Hoyos Duque,  . - 2018. Obra : Clinics and Research in Hepatology and Gastroenterology Idioma : Inglés (eng) Palabras clave : Liver cancer  epidemiology  transplantation  steatohepatitis Resumen : Background and aim: Non-alcoholic fatty liver disease (NAFLD) is an increasing cause of hepatocellular carcinoma (HCC) and liver transplantation (LT). Our study focused on changing trends of liver related HCC etiologies during the last years in Latin America.Methods: From a cohort of 2761 consecutive adult LT patients between 2005 and 2012 in 17 different centers, 435 with HCC were included. Different periods including years 2005—2006, 2007—2008, 2009—2010 and 2011—2012 were considered. Etiology of liver disease was confirmed in the explant. Results: Participating LT centers per country included 2 from Brazil (n = 191), 5 transplant programs from Argentina (n = 98), 2 from Colombia (n = 65), 4 from Chile (n = 49), 2 from Mexico (n = 12), and 1 from Peru (n = 11) and Uruguay (n = 9). Chronic hepatitis C infection was the leading cause of HCC in the overall cohort (37%), followed by HBV (25%) and alcoholic liver disease (17%). NAFLD and cryptogenic cirrhosis accounted for 6% and 7%, respectively. While HCV decreased from 48% in 2005—06 to 26% in 2011—12, NAFLD increased from 1.8% to 12.8% during the same period, accounting for the third cause of HCC. This represented a 6-fold increase in NAFLD-HCC, whereas HCV had a 2-fold decrease. Patients with NAFLD were older, had lower pre-LT serum AFP values and similar 5-year survival and recurrence rates than non NAFLD. Conclusion: There might be a global changing figure regarding etiologies of HCC in Latin America. This epidemiological change on the incidence of HCC in the world, although it has been reported, should still be confirmed in prospective studies. Mención de responsabilidad : Federico Piñero, Paulo Costa, Yuri Longatto Boteon, Sergio Hoyos Duque, Sebastian Marciano, Margarita Anders, Adriana Varón, Alina Zerega, Jaime Poniachik, Alejandro Soza, Martín Padilla Machaca, Josemaría Menéndez, Rodrigo Zapata, Mario Vilatoba, Linda Muñoz, Martín Maraschio, Luis G Podestá, Lucas McCormack, Adrian Gadano, Ilka S F Fatima Boin, Parente García, Marcelo Silva, Latin American Liver Research, Education, Awareness Network LALREAN Referencia : Clin Res Hepatol Gastroenterol. 2018 Oct;42(5):443-452. DOI (Digital Object Identifier) : 10.1016/j.clinre.2018.03.014 PMID : 29773419 En línea : https://linkinghub.elsevier.com/retrieve/pii/S2210-7401(18)30074-3 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4181

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Results of Liver Transplantation for Hepatocellular Carcinoma in a Multicenter Latin American Cohort Study / Sergio Iván Hoyos Duque  

Público ISBD Título : Results of Liver Transplantation for Hepatocellular Carcinoma in a Multicenter Latin American Cohort Study Tipo de documento : documento electrónico Autores : Sergio Iván Hoyos Duque, Fecha de publicación : 2018 Títulos uniformes : Annals of Hepatology Idioma : Inglés (eng) Palabras clave : Liver cancer  prediction  candidate selection. Resumen : Background and aims: Heterogeneous data has been reported regarding liver transplantation (LT) for hepatocellular carcinoma (HCC) in Latin America. We aimed to describe treatment during waiting list, survival and recurrence of HCC after LT in a multicenter study from Latin America. Material and methods: Patients with HCC diagnosed prior to transplant (cHCC) and incidentally found in the explanted liver (iHCC) were included. Imaging-explanted features were compared in cHCC (non-discordant if pre and post-LT were within Milan, discordant if pre-LT was within and post-LT exceeding Milan). Results: Overall, 435 patients with cHCC and 92 with iHCC were included. At listing, 81% and 91% of cHCC patients were within Milan and San Francisco criteria (UCSF), respectively. Five-year survival and recurrence rates for cHCC within Milan, exceeding Milan/within UCSF and beyond UCSF were 71% and 16%; 66% and 26%; 46% and 55%, respectively. Locoregional treatment prior to LT was performed in 39% of cHCC within Milan, in 53% beyond Milan/within UCSF and in 83% exceeding UCSF (p 1,000 ng/mL 64%; p = 0.12). Discordant imaging-explanted data was observed in 29% of cHCC, showing lower survival HR 2.02 (CI 1.29; 3.15) and higher recurrence rates HR 2.34 when compared to AFP 1,000 ng/mL at listing was independently associated with a higher 5-year recurrence rate and a HR of 3.24 when compared to AFP Mención de responsabilidad : Federico Piñero, Paulo Costa, Yuri L Boteon, Sergio Hoyos Duque, Sebastian Marciano, Margarita Anders, Adriana Varón, Alina Zerega, Jaime Poniachik, Alejandro Soza, Martín Padilla Machaca, Josemaría Menéndez, Rodrigo Zapata, Mario Vilatoba, Linda Muñoz, Martín Maraschio, Martín Fauda, Lucas McCormack, Adrian Gadano, Ilka Sf Boin, Jose H Parente García, Marcelo Silva Referencia : Ann Hepatol. 2018 Mar 1;17(2):256-267. DOI (Digital Object Identifier) : 10.5604/01.3001.0010.8648 PMID : 29469048 En línea : https://linkinghub.elsevier.com/retrieve/pii/S1665268119301589 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4188 Results of Liver Transplantation for Hepatocellular Carcinoma in a Multicenter Latin American Cohort Study [documento electrónico] / Sergio Iván Hoyos Duque,  . - 2018. Obra : Annals of Hepatology Idioma : Inglés (eng) Palabras clave : Liver cancer  prediction  candidate selection. Resumen : Background and aims: Heterogeneous data has been reported regarding liver transplantation (LT) for hepatocellular carcinoma (HCC) in Latin America. We aimed to describe treatment during waiting list, survival and recurrence of HCC after LT in a multicenter study from Latin America. Material and methods: Patients with HCC diagnosed prior to transplant (cHCC) and incidentally found in the explanted liver (iHCC) were included. Imaging-explanted features were compared in cHCC (non-discordant if pre and post-LT were within Milan, discordant if pre-LT was within and post-LT exceeding Milan). Results: Overall, 435 patients with cHCC and 92 with iHCC were included. At listing, 81% and 91% of cHCC patients were within Milan and San Francisco criteria (UCSF), respectively. Five-year survival and recurrence rates for cHCC within Milan, exceeding Milan/within UCSF and beyond UCSF were 71% and 16%; 66% and 26%; 46% and 55%, respectively. Locoregional treatment prior to LT was performed in 39% of cHCC within Milan, in 53% beyond Milan/within UCSF and in 83% exceeding UCSF (p 1,000 ng/mL 64%; p = 0.12). Discordant imaging-explanted data was observed in 29% of cHCC, showing lower survival HR 2.02 (CI 1.29; 3.15) and higher recurrence rates HR 2.34 when compared to AFP 1,000 ng/mL at listing was independently associated with a higher 5-year recurrence rate and a HR of 3.24 when compared to AFP Mención de responsabilidad : Federico Piñero, Paulo Costa, Yuri L Boteon, Sergio Hoyos Duque, Sebastian Marciano, Margarita Anders, Adriana Varón, Alina Zerega, Jaime Poniachik, Alejandro Soza, Martín Padilla Machaca, Josemaría Menéndez, Rodrigo Zapata, Mario Vilatoba, Linda Muñoz, Martín Maraschio, Martín Fauda, Lucas McCormack, Adrian Gadano, Ilka Sf Boin, Jose H Parente García, Marcelo Silva Referencia : Ann Hepatol. 2018 Mar 1;17(2):256-267. DOI (Digital Object Identifier) : 10.5604/01.3001.0010.8648 PMID : 29469048 En línea : https://linkinghub.elsevier.com/retrieve/pii/S1665268119301589 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4188

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Liver transplantation for hepatocellular carcinoma: evaluation of the alpha-fetoprotein model in a multicenter cohort from Latin America / Sergio Iván Hoyos Duque  

Público ISBD Título : Liver transplantation for hepatocellular carcinoma: evaluation of the alpha-fetoprotein model in a multicenter cohort from Latin America Tipo de documento : documento electrónico Autores : Sergio Iván Hoyos Duque, Fecha de publicación : 2016 Títulos uniformes : Liver International Idioma : Inglés (eng) Palabras clave : Alpha-fetoprotein  candidate selection  liver cancer  prediction Resumen : Background & Aims: The French alpha‐fetoprotein (AFP) model has recently shown superior results compared to Milan criteria (MC) for prediction of hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT) in European populations. The aim of this study was to explore the predictive capacity of the AFP model for HCC recurrence in a Latin American cohort. Methods: Three hundred twenty‐seven patients with HCC were included from a total of 2018 patients transplanted at 15 centres. Serum AFP and imaging data were both recorded at listing. Predictability was assessed by the Net Reclassification Improvement (NRI) method. Results: Overall, 82 and 79% of the patients were within MC and the AFP model respectively. NRI showed a superior predictability of the AFP model against MC. Patients with an AFP score >2 points had higher risk of recurrence at 5 years Hazard Ratio (HR) of 3.15 (P = 0.0001) and lower patient survival (HR = 1.51; P = 0.03). Among patients exceeding MC, a score ≤2 points identified a subgroup of patients with lower recurrence (5% vs 42%; P = 0.013) and higher survival rates (84% vs 45%; P = 0.038). In cases treated with bridging procedures, following restaging, a score >2 points identified a higher recurrence (HR 2.2, P = 0.12) and lower survival rate (HR 2.25, P = 0.03). A comparative analysis between HBV and non‐HBV patients showed that the AFP model performed better in non‐HBV patients. Conclusions: The AFP model could be useful in Latin‐American countries to better select patients for LT in subgroups presenting with extended criteria. However, particular attention should be focused on patients with HBV. Mención de responsabilidad : Federico Piñero, Matías Tisi Baña, Elaine Cristina de Ataide, Sergio Hoyos Duque, Sebastian Marciano, Adriana Varón, Margarita Anders, Alina Zerega, Josemaría Menéndez, Rodrigo Zapata, Linda Muñoz, Martín Padilla Machaca, Alejandro Soza, Lucas McCormack, Jaime Poniachik, Luis G Podestá, Adrian Gadano, Ilka S F Fatima Boin, Christophe Duvoux, Marcelo Silva, Latin American Liver Research, Education and Awareness Network LALREAN Referencia : Liver Int. 2016 Nov;36(11):1657-1667. DOI (Digital Object Identifier) : 10.1111/liv.13159 PMID : 27169841 En línea : https://onlinelibrary.wiley.com/doi/abs/10.1111/liv.13159 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3982 Liver transplantation for hepatocellular carcinoma: evaluation of the alpha-fetoprotein model in a multicenter cohort from Latin America [documento electrónico] / Sergio Iván Hoyos Duque,  . - 2016. Obra : Liver International Idioma : Inglés (eng) Palabras clave : Alpha-fetoprotein  candidate selection  liver cancer  prediction Resumen : Background & Aims: The French alpha‐fetoprotein (AFP) model has recently shown superior results compared to Milan criteria (MC) for prediction of hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT) in European populations. The aim of this study was to explore the predictive capacity of the AFP model for HCC recurrence in a Latin American cohort. Methods: Three hundred twenty‐seven patients with HCC were included from a total of 2018 patients transplanted at 15 centres. Serum AFP and imaging data were both recorded at listing. Predictability was assessed by the Net Reclassification Improvement (NRI) method. Results: Overall, 82 and 79% of the patients were within MC and the AFP model respectively. NRI showed a superior predictability of the AFP model against MC. Patients with an AFP score >2 points had higher risk of recurrence at 5 years Hazard Ratio (HR) of 3.15 (P = 0.0001) and lower patient survival (HR = 1.51; P = 0.03). Among patients exceeding MC, a score ≤2 points identified a subgroup of patients with lower recurrence (5% vs 42%; P = 0.013) and higher survival rates (84% vs 45%; P = 0.038). In cases treated with bridging procedures, following restaging, a score >2 points identified a higher recurrence (HR 2.2, P = 0.12) and lower survival rate (HR 2.25, P = 0.03). A comparative analysis between HBV and non‐HBV patients showed that the AFP model performed better in non‐HBV patients. Conclusions: The AFP model could be useful in Latin‐American countries to better select patients for LT in subgroups presenting with extended criteria. However, particular attention should be focused on patients with HBV. Mención de responsabilidad : Federico Piñero, Matías Tisi Baña, Elaine Cristina de Ataide, Sergio Hoyos Duque, Sebastian Marciano, Adriana Varón, Margarita Anders, Alina Zerega, Josemaría Menéndez, Rodrigo Zapata, Linda Muñoz, Martín Padilla Machaca, Alejandro Soza, Lucas McCormack, Jaime Poniachik, Luis G Podestá, Adrian Gadano, Ilka S F Fatima Boin, Christophe Duvoux, Marcelo Silva, Latin American Liver Research, Education and Awareness Network LALREAN Referencia : Liver Int. 2016 Nov;36(11):1657-1667. DOI (Digital Object Identifier) : 10.1111/liv.13159 PMID : 27169841 En línea : https://onlinelibrary.wiley.com/doi/abs/10.1111/liv.13159 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3982

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